BEUDAMED
    FDA Adverse Event Other Summary report: N

    HOYER LIFT W/6PTWSC

    MDR report key: 1785044 · Received March 10, 2010

    Report

    Report Number
    2182305-2010-00006
    Event Type
    Other
    Date Received
    March 10, 2010
    Date of Event
    January 30, 2010
    Report Date
    February 19, 2010
    Manufacturer
    IMS, INC, INTEGRATED MEASUREMENT SYSTEM
    Product Code
    FNG
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED TO MFR, BY FACILITY, (B)(6), PER FACILITY OVER THE WEEK-END THEY WERE USING THE LIFT TO TRANSFER A RESIDENT WHEN THE MAIN BOLT THAT COMES OUT OF THE TOP OF THE SCALE BROKE OFF CAUSING THE RESIDENT TO FALL. THE RESIDENT WAS OVER THEIR BED AT THE TIME AND FELL BACK ONTO THEIR BED; NO INJURY WAS REPORTED. THIS WILL BE REPORTED AS A COULD HAVE CAUSED OR CONTRIBUTED TO AN INJURY. (B)(4) WAS ISSUED TO GET SPREADER BAR AND SCALE BACK FOR EVAL. IN ADDITION THE MFR OF THE SCALE HAS BEEN NOTIFIED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HOYER LIFT W/6PTWSC PATIENT LIFTER W/SCALE FNG IMS, INC, INTEGRATED MEASUREMENT SYSTEM PRESENCE W/6POINT SCALE

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Other